HomeMy WebLinkAboutPermit Mechanical 2007-10-17 (2)
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SCAi~NED
.CITY OF SPRIN'GFIELD
Building/Combination Permit
PERMIT NO: COM2007-01560
ISSUED: 10/17/2007
APPLIED: 10/17/2007
EXPIRES: 04/17/2008
VALUE:
Status
Issued
SITE ADDRESS: 724 CREST LN
ASSESSOR'S PARCEL NO.: 1703341407901
Springfield
TYPE OF WORK: Heating System
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Pellet Stove Insert
Owner: MCCLURG DAVID P & JA YLENE
Address: 724 CREST LN
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
AMBASSADOR PIPING INC
License
121469
Expiration Date
03/27/2009
Phone
541-726-5723
BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION'
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
I
Compact:
I PUBLIC IMPROVEl\tl~l~ 1 S I
Street Improvements:
Sidewalk Type:
~tor~ ISIewlft'\r~~r8~! Oregon law requires you to
pecla ~orrig~\'IUIJ~~ adopted by the Oregon Utility
Notification Center. Those rules are set forth
Notes: In OAR 952-001-0010 through OAR 952-001- U\!l(Q)f~~fE:
nt\nn v..." ......"'\' "h+ain Mnio~ nf thp n lip!,: hv nJI~ O!:tlI\IIIT ~,",AII FXPIRE IF THE WORK
. calling the center. (Noie:.t.he te'~fJi,u'.'l;: . .. JTHORIZED UNDER THIS PERMIT IS NOT
numbsi' for the Oregon Utility Nc " Ion Descn hon MMENCED OR IS ABANDONED FOR
Center is 1-800-332-2344).
$ Per Sq Ft Squarek\~c\tag~O DAY PERIOD,
It' I' B'd A Value
or mu Ip ler or I mount
DownspoutslDrains:
Description
Type of Construction
Date Calculated
Pa2e 1 of2
.
.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01560
ISSUED: 10/17/2007
APPLIED: 10/17/2007
EXPIRES: 04/17/2008
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following.
work day.
I Reguired InsRections I
Pellet Insert: After installation
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I
further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
M
/0-1/-07
Owner or Contractors Signature
Date
Paee 2 of2
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SPRiNGFIELD
CITY OF SPRINGFIELD, OREGON
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225 FIITH STREET. SPRINGFIELD, OR 97477. PH:(541)726-3753 · FAX: (541)726-3689
City Job Number Com 2.OrJl,..... () iSba
Job Location: '7~4 (K-e~ 1.~
Assessor's Map:
Tax Lot:
Owner: -r l)(~i d /l1 (. CIt'/'5'
Address: 7:2 i{ C-te$ I /'.11.
City: -spth/
v
State:
Phone: 7Yt -~~ n
/)Jr, Zip: e:1;?t-!,/?
,
Preliminary Inspection for wood burning inserts is $61.50 (prior to insert)..
Wood Stove/Pellet/Insert Permit is $71.50 (includes applicable fees and surcharges).
Contractor Infvuuation
Contractor: A~~~ ~plj 1i?1'1~, '
Address: f. () & ../ ")6? .3 ?
City: ~l.J~. State: t?/..
Construction Contractor's Registration #: l.2.J t//; "-
,Phone: 7:k; - 5-:/a?3
Zip: 9 ?S/~/
Expires:
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769).
I state that all information on this application/permit is correct and that I was provided with
the Wood Stove Safety information for wood burning appliances and preliminary inspection
standards as set by the Oregon Department of Environmental Quality or the Federal
Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand thatif I am requesting a preliminary
inspection, the wall covering may be required to be removed.
Signature:
!1@? }(~)
Date:
/o-/7-~?
Date of Application: / 6 Jrr I () f/
( /
Checked for Delinquencies: L/' Checked for Historical Status:
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Shared Drive(T:)/Building FonnsIWood Stove Permit7-07,doc